Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial.
Background: Multiple sclerosis is associated with muscle stiffness, spasms, pain, and tremor. Much anecdotal evidence suggests that cannabinoids could help these symptoms. Our aim was to test the notion that cannabinoids have a beneficial effect on spasticity and other symptoms related to multiple s...
| Publicado en: | Lancet Vol. 362; no. 9395; pp. 1517 - 1527 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Lancet
11/8/2003
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106576709&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106576709 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 11/8/2003 vid: 362 iid: 9395 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 106576709 106576709 NLM14615106 2005032340 10.1016/s0140-6736(03)14738-1 NLM14615106 106576709 ppf: 1517 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. aug: au: Zajicek J Fox P Sanders H Wright D Vickery J Nunn A Thompson A Zajicek, John Fox, Patrick Sanders, Hilary Wright, David Vickery, Jane Nunn, Andrew Thompson, Alan affil: Peninsula Medical School, Plymouth, UK sug: subj: Cannabis Therapeutic Use Multiple Sclerosis Drug Therapy Muscle Spasticity Drug Therapy Barthel Index Cannabis Adverse Effects Clinical Trials Confidence Intervals Data Analysis Software Double-Blind Studies Female Kruskal-Wallis Test Male Middle Age Nonparametric Statistics One-Way Analysis of Variance Physical Mobility Questionnaires Random Assignment Scales Treatment Outcomes United Kingdom Funding Source Human Middle Aged: 45-64 years Female Male ab: Background: Multiple sclerosis is associated with muscle stiffness, spasms, pain, and tremor. Much anecdotal evidence suggests that cannabinoids could help these symptoms. Our aim was to test the notion that cannabinoids have a beneficial effect on spasticity and other symptoms related to multiple sclerosis.Methods: We did a randomised, placebo-controlled trial, to which we enrolled 667 patients with stable multiple sclerosis and muscle spasticity. 630 participants were treated at 33 UK centres with oral cannabis extract (n=211), Delta9-tetrahydrocannabinol (Delta9-THC; n=206), or placebo (n=213). Trial duration was 15 weeks. Our primary outcome measure was change in overall spasticity scores, using the Ashworth scale. Analysis was by intention to treat.Findings: 611 of 630 patients were followed up for the primary endpoint. We noted no treatment effect of cannabinoids on the primary outcome (p=0.40). The estimated difference in mean reduction in total Ashworth score for participants taking cannabis extract compared with placebo was 0.32 (95% CI -1.04 to 1.67), and for those taking Delta9-THC versus placebo it was 0.94 (-0.44 to 2.31). There was evidence of a treatment effect on patient-reported spasticity and pain (p=0.003), with improvement in spasticity reported in 61% (n=121, 95% CI 54.6-68.2), 60% (n=108, 52.5-66.8), and 46% (n=91, 39.0-52.9) of participants on cannabis extract, Delta9-THC, and placebo, respectively.Interpretation: Treatment with cannabinoids did not have a beneficial effect on spasticity when assessed with the Ashworth scale. However, though there was a degree of unmasking among the patients in the active treatment groups, objective improvement in mobility and patients' opinion of an improvement in pain suggest cannabinoids might be clinically useful. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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